Nurses s are a powerful force for change in healthcare, and by recognizing their critical role and providing them with the support they need, healthcare providers can work together to improve healthcare delivery and promote better health outcomes for individuals and communities around the world. However, they are under much stress that needs to be seriously addressed.
MENTAL HEALTH ISSUES OF NURSES
Impending long shift duties trigger anxiety and stress among nurses.
Nurses are sleeping, on an average, less than recommended, because of the sheer length of their work shift, which may be impacting their health and performance on the job. Work-related anxiety is the commonest mental health issue reported by professional nurses, followed by depression and stress.
Common mental health issues experienced by the Indian nurses were fear, burnout, anxiety and fatigue, followed by stress, depression, insomnia and work-life imbalance. Nurses around the experience similar kinds of mental health issues.
GRIEVANCES OF NURSES
Nurses in India battle low pay and long hours, even as hospitals struggle to find skilled hands in the absence of quality training.
In many hospitals, nurses, who are freshers, and join after completing the General Nursing and Midwifery (GNM) diploma, are paid as low as Rs 8,000 per month in small nursing homes in urban areas, while it is even lower in rural areas at Rs 6,000 per month.
Corporate hospitals pay Rs 11,500 per month for freshers, but in many hospitals, even senior nurses are paid more or less the same. In the case of nurses who have completed BSc (nursing), pay in rural hospitals remains the same as diploma holders, while in corporate hospitals, they are paid Rs 12,900 per month when they join as freshers.
India’s nursing workforce is about two-thirds of its health workforce. Its ratio of 1.7 nurses per 1,000 population is 43% less than the World Health Organisation norm. It needs 2.4 million nurses to meet the norm.
According to Indian Nursing Council recent records, there are around 33.41 lakh registered nursing personnel, including 23,40,501 registered nurses and registered midwives, and 10,00,805 nurse associates (9,43,951 Auxiliary Nurse Midwives), and 56,854 lady health visitors in the country.
According to the World Health Organisation (WHO), globally, nurses makeup 59 per cent of the healthcare workforce. A World Health Report of 2006 reveals that 70% of the doctors are male and 70% nurses are female. In India, more than 90% of the nurses are women. In the rigid healthcare hierarchy, nurses are not considered independent professionals but are dominated by physicians and hospital managements.
Most health authorities, physicians and politicians acknowledge that nurses are the backbone of both health system and hospital but when nurses demand autonomy and legal recognition or even basic facilities like changing rooms, toilets and conducive work environments, they go unheard.
Over the years, the role of the nurse has evolved. They are the backbone of the healthcare system.
What makes the nursing profession unique is the complete dedication to the call of duty that is way beyond any financial gain. Without their compassion, dedication and hard work, the system would instantly collapse.
There is something unique about being at the bedside of a patient, taking the time and effort to understand every individual patient and addressing their unique needs.
It is inescapable that the nursing profession has always been underpaid and undervalued because most nurses (four out of five) are women. The overlaps with ‘lower’ caste and minority religion are also plainly visible. Most hospitals’ nurses are now hired on temporary contracts, extended for year after year – trapping them in ad hoc, insecure employment. The refusal to regularise nurses, in private or government employment, is the central issue of nurses welfare. It has left trained nurses with not much to look forward to, except going overseas – and that has left India’s medical system grimly understaffed, with fewer than two nurses for every thousand people in the country.
(Dr. Naresh Purohit is Executive Member, Federation of Hospital Administrator. The views and opinion expressed in this article are those of the author.)